It’s been nearly a year since skilled nursing providers first raised the alarm about the financial crisis being created by exorbitant agency staffing costs and anti-competitive behaviors.
This week, the Illinois Legislature decided to do something about it.
New rules there aim to limit aggressive agency contracts that discouraged nurses from choosing full-time, direct employment with a nursing home if they liked the assignment. The labor rules also give state officials a needed window into nurse and certified nurse aide pay rates established in contracts with providers.
Presumably, being able to track pricing will help In the next staffing emergency, or provide a basis for establishing the kinds of caps other states have adopted (some before and some during the pandemic). Because by many accounts, the interventions coming now are too late to address the urgent pleas for help made this time around.
Many healthcare providers report their agency use is far off the pandemic’s peak, and nationwide, pricing has started to level off as demand recedes.
This column will not be made earth-shattering by my pronouncement that the wheels of government turn far too slow for comfort.
National associations first beseeched the Federal Trade Commission to intervene in agency staffing, officially at least, in October 2021. But on this issue, as many others before it, nursing homes were essentially left to navigate the maze alone.
In some states, provider associations were able to affect some change or at least trigger lawmaker interest in the issue. Illinois nursing home representatives had hoped for caps this year, but, hey, beggars can’t be choosers. And in this case, nursing homes outright begged for help to anyone who would listen.
Of course, they’d been down this road before. Few waited to be rescued. Instead, while they learned to become better advocates in their state capitals, they also went after their own solutions.
It was slow going, but eventually they found ways to return agency to its rightful and limited place. They hired more non-medical staff to help assist in-house staff with routine patient needs; they formed in-house agencies to incentivize workers to cover shifts in other locations; and, of course, they raised their own pay rates and increased flexibility to attract their own staff (all at greater cost to the taxpayer, mind you).
Having thoroughly covered staffing issues throughout much of 2021 and this year, I’m glad to see Illinois make some permanent changes that introduce more transparency to the travel and temporary nurse staffing sector.
But the picture has been clear for a while now: Some unscrupulous agencies took advantage of nursing homes desperate for the staff they needed to care for residents and remain open, and elected officials at multiple levels of government sat on their hands in the middle of a public health emergency and did nothing about it.
The bigger picture, one that I hope regulators can see too, is that countless skilled nursing providers across the country proved their resourcefulness when left with this pressing problem.
That fix-it-to-make-it attitude should be given credence as regulators pursue with vigor other, new rules for nursing homes — rules that seem to be coming down the pike fast when no one asked for them, and when some may in fact be counterproductive in the current labor environment.
For any lawmakers who still wonder what nursing homes need, or how they can reach their goals, this might be a good time to ask them. Unlike some, they’ll probably have an answer quickly.
Kimberly Marselas is senior editor of McKnight’s Long-Term Care News.
Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.